Journal Thoracic Oncology

Abstracts Journal of Thoracic Oncology • Volume 12 Issue S1 January 2017
knockdown of miR-1275 affected proteins relating to cell proliferation and
apoptosis. Bioinformatics showed SPOCK1 might be one of the targets of
miRNA-1275. Conclusion: Our results contribute to understand molecular
mechanisms of T790M-mediated EGFR-TKI resistance, but also provide a new
therapeutic strategy for patients in advanced NSCLC to aid expansion of the
effectiveness of TKI treatment through radiotherapy.
Keywords: EGFR-TKI, Acquried resistance, radiation, T790M
POSTER SESSION 2 – P2.05: RADIOTHERAPY
Clinical Outcome –
TUESDAY, DECEMBER 6, 2016
P2.05-006 RADIOTHERAPY AS DEFINITIVE TREATMENT IN
PATIENTS AGED 70 YEARS AND OLDER WITH NON-SMALL CELL
LUNG CANCER
Sureyya Sarihan 1 , Türkkan Evrensel 2 , Deniz Sigirli 3
1 Radiation Oncology, Uludag University, Faculty of Medicine, Bursa/Turkey,
2 Medical Oncology, Uludag University, Faculty of Medicine, Bursa/Turkey,
3 Biostatistics, Uludag University, Faculty of Medicine, Bursa/Turkey
Background: The factors affecting survival were evaluated in patients aged
≥ 70 years with non-small cell lung cancer (NSCLC) treated with definitive
radiotherapy (RT). Methods: Between January 1996 and April 2012, 52 patients
were treated. The median age was 73 (range: 70-80), 73% and 75% of patients
with stage III according to AJCC 2002 and 2010, respectively. Radiotherapy
was performed median 6160 cGy (range: 3600-6660) and chemotherapy (CHE)
were given 75% of the patients as neoadjuvant, concurrent or adjuvant.
Statistical analysis were calculated with Kaplan-Meier and Cox regression
methods. Results: Median follow-up was 12.5 months (range: 2.5-103). Median
overall (OS), disease-free (DFS) and locoregional-progression-free (LRPFS)
survival were 22 (95% CI 12-31), 18.5 (95% CI 7-29) and 25 months (95% CI 15-
34), respectively. Two-year OS, DFS and LRPFS rates were 50%, 47% and 52%,
respectively. Acute ≥ Grade 3 esophagitis and neutropenia were seen 6% and
10% of patients. Whereas the mortality associated with CHE were seen of 5
(10%) patients, RT-related death was not observed. In univariate analysis;
AJCC 2002 stage I-II (72.5 vs 20 months, p = 0.05), RT dose ≥ 60 Gy (27.5 vs 12.5
months, p = 0.01), RT duration >49 days (31 vs 11 months, p 49 days (26.5 vs 10.5
months, p 49 days were found a positive impact on OS (HR: 3.235, 95% CI: 1:25
to 8:32 p = 0.01). Conclusion: Definitive and pallliative RT plays an important
role in elderly lung cancer patients have multiple co-morbidities with limited
treatment options. In our study, elderly patients with NCSLC can be given ≥ 60
Gy without complications and was seen positively impact on survival.
Keywords: survival, non-small cell lung cancer, Elderly patients, Radiotherapy
POSTER SESSION 2 – P2.05: RADIOTHERAPY
CLINICAL OUTCOME –
TUESDAY, DECEMBER 6, 2016
P2.05-007 OUTCOMES AFTER STEREOTACTIC BODY RADIOTHRAPY/
PROTON BEAM THERAPY OR WEDGE RESECTION FOR STAGE I NON-
SMALL-CELL LUNG CANCER
Yasuhisa Ohde 1 , Hideyuki Harada 2 , Shoko Hayashi 1 , Kiyomichi Mizuno 3 ,
Yoshiyuki Yasuura 1 , Reiko Shimizu 1 , Hiroyuki Kayata 1 , Hideaki Kojima 1 , Shoji
Takahashi 1 , Mitsuhiro Isaka 1 , Toshiaki Takahashi 4 , Shigeyuki Murayama 2 ,
Tetsuo Nishimura 2 , Keita Mori 5
1 Thoracic Surgery, Shizuoka Cancer Center, Shizuoka/Japan, 2 Radiation and Proton
Beam Therapy Center, Shizuoka Cancer Center, Shizuoka/Japan, 3 Shizuoka Cancer
Center, Shizuoka/Japan, 4 Thoracic Oncology, Shizuoka Cancer Center, Shizuoka/
Japan, 5 Clinical Research Center, Shizuoka Cancer Center, Shizuoka/Japan
Background: Recently, excellent results of stereotactic body radiotherapy
(SBRT), proton beam therapy (PBT) for stage I non-small-cell lung cancer
(NSCLC) have been reported, however any phase III trial comparing SBRT and
surgery have not been completed yet. The aim of this study is to compare
outcomes between SBRT, PBT and wedge resection (WR) for patients with
peripheral stage I NSCLC who intolerable for anatomical resection, and
analyze prognostic factors in this population. Methods: We retrospectively
compared overall survival (OS), local recurrence rate (LRR), relapse-free
survival (RFS) and cause-specific survival (CSS) between WR (n=172) and SBRT
/ PBT (n=188) for pathologically proven clinical stage I NSCLC in our institute
from 2002 to 2015. Patients underwent WR were all high risk patients who
intolerable for anatomical resection and achieved complete resection without
any adjuvant therapy. Of radiation group (RT: SBRT+PBT), 56% was medically
inoperable, with 44% refusing surgery. SBRT; 60 Gy in 8 fractions, PBT; 60-80
GyE in 10-20 fractions was prescribed. Propensity score matching was used to
adjust the confounding effects in estimating treatment hazard ratios. 59 WR
patients and 59 radiotherapy (RT) patients (SBRT 27, PBT 32) were matched
blinded to outcome (1:1 ratio). There are 70 men and 48 women, median age
was 81, and median follow-up period was 39 months. Results: 3, 5 - year overall
survival (OS) of WR and RT was 84.5%, 70.8% vs 89.7%, 59.6% (p=0.802),
respectively. 3-year LRR, RFS, CSS were 94.7% vs 95.9% (p=0.751), 87.5% vs
75.6% (p=0.151) and 91.2% vs 93.9% (p=0.875), respectively. Multivariate
analysis of prognostic factors for OS demonstrated any factors including
treatment modality were not significant. Conclusion: Our results suggest that
the treatment outcome of SBRT / PBT was equivalent to that of WR, SBRT /
PBT may be alternative treatment in stage I NSCLC high risk patients.
Keywords: SBRT, Surgery, lung cancer
POSTER SESSION 2 – P2.05: RADIOTHERAPY
CLINICAL OUTCOME –
TUESDAY, DECEMBER 6, 2016
P2.05-008 CAN STEREOTACTIC BODY RADIATION THERAPY (SBRT)
BE AN EFFECTIVE TREATMENT FOR LUNG METASTASES FROM
“RADIORESISTANT” HISTOLOGIES?
Davide Franceschini, Fiorenza De Rose, Luca Cozzi, Tiziana Comito, Ciro
Franzese, Pierina Navarria, Giuseppe D’Agostino, Marta Scorsetti
Radiotherapy and Radiosurgery, Humanitas Clinical and Research Center, Rozzano
Milano/Italy
Background: Metastasis from “radioresistant” histologies are commonly
regarded as less responsive to SBRT. Almost no data are available in Literature
to evaluate the impact of these histologies on the outcome of patients with
lung metastases treated with Stereotactic Body Radiation Therapy (SBRT).
Therefore, we conducted this analysis on patients with lung metastases from
renal cell carcinoma, hepatocellular carcinoma, adenoid cystic carcinoma and
melanoma treated with SBRT in our Institution. Methods: Oligometastatic
patients with lung metastases from renal cell carcinoma, hepatocellular
carcinoma, adenoid cystic carcinoma and melanoma who received SBRT and
with a discrete follow up time were included in this analysis. Kaplan Meyer
analysis was used to calculate Overall Survival, Progression Free Survival,
Local Control. Crude rates were used to calculate the response and distant
failure rates. Toxicity was scored according to CTCAE v. 4.03 Results: Sixty
patients were included in the study. Most common primary histologies were
renal cell carcinoma and hepatocellular carcinoma. Most of patients had 1 or
2 metastatic sites. Half patents did not receive any systemic therapy during
their history before SBRT. Different RT doses and number of fractions were
utilized according to site, number and volume of lung metastases, 48 Gy
in 4 fractions was the most commonly prescribed schedule. The best local
responses obtained were complete response in 13 patients (21.7%), partial
response in 28 patients (46.7%) and stable disease in 14 patients (23.3%).
Five patients (8.3%) had a local progression. With a median follow up of 24.3
months (range 4.1-118.6 months), local control was 93.7% and 86.1% at 1 and 2
years respectively. OS and PFS at 1 and 2 year were 89.5%, 64.6%, 87.7% and
70.1%, respectively. None of the analyzed parameters showed a statistically
significant impact on any outcome. Treatment was well tolerated. None but
one patients experienced acute toxicity of any grade. During follow up in 10
cases G1-2 toxicity (mostly pneumonia) were recorded. Conclusion: SBRT for
lung metastases is an effective treatment for oligometastatic patients with
lung metastases from “radioresistant” histologies. The treatment is safe and
well tolerated and the outcomes are equivalent to the results obtainable with
SBRT for lung metastases from more favourable histologies.
Keywords: Stereotactic body radiation therapy, Oligometastases,
Radioresistance, lung metastases
POSTER SESSION 2 – P2.05: RADIOTHERAPY
CLINICAL OUTCOME –
TUESDAY, DECEMBER 6, 2016
P2.05-009 THE OUTCOME AND ADVERSE EVENT OF
CHEMORADIATION ± SURGERY FOR STAGE III NON-SMALL CELL
LUNG CANCER
Shigehiro Kudo 1 , Yoshihiro Saito 1 , Hiroki Ushijima 1 , Yu Okubo 1 , Tomoko
Kazumoto 2 , Jun-Ichi Saito 3 , Hideaki Mizutani 4 , Yuki Yamane 4 , Junko Sudo 4 ,
Futoshi Kurimoto 4 , Hiroshi Sakai 4 , Yuki Nakajima 5 , Hiroyasu Kinoshita 5 ,
Hirohiko Akiyama 5
S542 Journal of Thoracic Oncology • Volume 12 Issue S1 January 2017